Parise et al reported a model for predicting delayed discharge following gastrectomy. The presence of certain red flags may delay discharge. The authors are from San Raffaele Hospital in Milan.
Patient selection: status post gastrectomy for gastric cancer, either total or distal
Outcome: expected date of discharge is 7-9 days after surgery
Parameters from the logistic regression model:
(1) preoperative immunonutrition completed (237 mL tid of Oral Impact for 5-7 days)
(2) patient extubated at the end of surgery
(3) early mobilization (within 24 hours of surgery)
(4) volume of intraoperative crystalloids in mL
(5) volume of intraoperative blood transfusion in mL
(6) duration of surgery in minutes
|
Parameter
|
Finding
|
Points
|
|
immunonutrition
|
no
|
0
|
|
|
yes
|
-1.587
|
|
extubation
|
no
|
0
|
|
|
yes
|
-22.238
|
|
early mobilization
|
no
|
0
|
|
|
yes
|
-1.225
|
|
volume crystalloids
|
<= 2,150 mL
|
0
|
|
|
> 2,150 mL
|
0.86
|
|
volume blood
|
<= 268 mL
|
0
|
|
|
> 268 mL
|
1.689
|
|
surgery duration
|
<= 195 minutes
|
0
|
|
|
> 195 minutes
|
1.62
|
value of X =
= SUM(points for all of the parameters) + 22.889
probability of delayed discharge =
= 1 / (1 + EXP((-1) * X))
Performance:
• The model correctly classified 74% of cases.
• The area under the ROC curve is 0.805
